Background: The integration of individual patients' preferences is paramount for patient-oriented care in oncology at the End of Life (EOL). The aim of this study was to explore patients' preferences for Quality (QL) or Length of Life (LL) and the factors influencing them. In addition, communication preferences of patients about limiting treatment were explored. Methods: We surveyed 194 cancer patients at the National Center for Tumour diseases and the Thorax Clinic at Heidelberg University using a set of questionnaires. Socio-demographic, clinical data, preferences regarding QL and LL, communication preferences cancer-related distress and family role in the decision-making were assessed. Results: Patients’ attitudes toward treatment could be categorized into striving for QL, striving for LL, and no clear preference. Patients’ preferences were slightly higher for QL (mean=3.5; SD=0.7) than for LL (mean=3.15; SD=0.9). Patients who indicated that their next of kin play an important role in therapeutic decisions were more likely to strive for LL (p=.01). Patients who preferred LL tended to avoid communications with their physicians about limiting treatment (p=.03) whereas patients who strived for QL preferred their physicians initiating this discussion early on (p=.00). Patients were predominantly men (68%); mean age was 63 years (SD=10.3). Age, gender, prognosis and cancer-related distress had no impact on preferences for QL or LL. Conclusions: Family involvement in treatment decisions had considerable impact on patients' preferences and was associated with patients striving for LL. Those patients did not want their oncologists to discuss treatment limitation with them. Hence, in orchestrating decision making about cancer specific treatment near the EOL it is important for oncologists to involve the family and enable the communication about realistic treatment goals early on.